2014 Young at Heart Award Online Nomination

AMA Young Physicians Section
2014 Young at Heart Award
Nomination Form

All nominees for the award should be AMA members who are not eligible for Section membership (i.e., over the age of 40 and/or within the first eight years of practice following completion of residency/fellowship and ineligible for membership in the AMA Resident and Fellows Section) whose support and guidance have strengthened the Young Physicians Section. This can be through:

  • organizational aid (such as developing a local young physicians section)
  • support of YPS issues in reference committees/caucuses or on the floor of the AMA House
  • support of YPS leadership development, i.e., promotion of YPS leaders.

Nominations are being accepted from AMA-YPS Assembly members through April 15, 2014.

The AMA-YPS Governing Council will consider all nominees, make a decision on the award recipient, and announce the winner in the 2014 Annual Meeting Delegate Handbook. The award will be given during the 2014 Annual AMA-YPS Assembly meeting in Chicago. To nominate an individual, complete the following online form.

The information you provide below is solely for the AMA's internal use and will not be reused or sold for any commercial purpose without your permission.

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Nomination from:
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Your email address:
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Name of physician you wish to nominate:*
 
 
Nominee's address:
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City:
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State:
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Rationale for nomination: